Ill. Admin. Code tit. 77, pt. 500, app H, ILLUSTRATION A

Current through Register Vol. 49, No. 2, January 10, 2025

Affidavit by Mother

STATE OF ILLINOIS

DEPARTMENT OF PUBLIC HEALTH

DIVISION OF VITAL RECORDS

SPRINGFIELD 62702-5097

NOTE: A CERTIFIED COPY OF YOUR MARRIAGE RECORD MUST ACCOMPANY THE COMPLETED AFFIDAVITS. AFFIDAVITS MUST BE SIGNED BEFORE A NOTARY PUBLIC OR THEY WILL NOT BE ACCEPTED.

AFFIDAVIT BY MOTHER

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Ill. Admin. Code tit. 77, pt. 500, app H, ILLUSTRATION A

Added at 15 Ill. Reg. 11706, effective August 1, 1991